Understanding Self-Inflicted Firearm Injuries Through Prior Hospitalizations

Self-inflicted firearm injuries are a significant public health concern and account for approximately two-thirds of firearm deaths in the United States. Previous research has shown increased self-inflicted firearm injuries in rural populations compared to urban areas. We hypothesize that hospitalization prior to self-inflicted firearm injury event is related to different characteristics in the urban and rural populations.

The 2016-2020 Nationwide Readmission Database of the Healthcare Cost and Utilization Project was used to identify hospital admissions within the same year prior to a self-inflicted firearm injury in patients > 12.

We identified 6883 self-inflicted firearm injury admissions with 1532 (22.3%) patients having prior admission to the hospital. Of those that survived, there were similar proportions in age groups and urban/rural designation. Rates for prior hospitalizations for suicide were 25% and 30% for the urban and rural cohorts, respectively. Prior to the self-inflicted firearm injury, urban and rural hospitalizations included: infection (41.4% vs 44.7%), mental health (20.8% vs 25.1%), drug/alcohol (8.2% vs 4.5%), and injury (3.6% vs 1.7%), respectively. No prior hospitalizations included other types of firearm injury. The most common diagnosis related groups were infection, mental health, and medical-related problems.

We found a 22.3% rate of previous hospitalization prior to self-inflicted firearm injury admission. Despite known differences in the urban and rural populations, hospital admission diagnoses prior to self-inflicted firearm injury are similar between these two groups.